Croup (Laryngotracheobronchitis) (PIC)
Disclaimer
These guidelines have been adopted to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.
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Paediatric Improvement Collaborative Clinical Practice Guideline
The following guideline has been endorsed by the National Paediatric Improvement Collaborative and should be used in conjunction with the relevant local guidelines.
The above link will take you to an external website.
Management of croup at Perth Children’s Hospital follows the evidence-based guidelines from the National Paediatric Improvement Collaborative (PIC).
The guideline should be used in conjunction with local policies and guidelines pertinent to the management of croup in your health service.
Please refer to the PIC Guidelines disclaimer.
Should you have any suggestions around improving the PIC CPGs, please complete the feedback form on the CPG website.
Nursing
- Minimal nursing intervention is encouraged to avoid distressing the child and increasing respiratory distress.
- Patients should remain in a position of comfort.
- Children with croup require close observation.
Observations
- Complete and record at least hourly a full set of observations on the age- appropriate Observation and Response Tool and record additional information on the Clinical Comments chart whilst in the Emergency Department.
- The presence or absence of the following clinical features should be assessed and documented –
- stridor
- barking cough
- degree and type of recession (i.e., mild, moderate, severe, intercostal, subcostal, tracheal tug)
- air entry
- cyanosis
- conscious state (normal or altered).
- Oxygen saturations and continuous cardiac monitoring is recommended if adrenaline (epinephrine) is given.
- Before applying consider whether the risk of distress negates the accuracy of monitoring.